TY - JOUR
T1 - The association of diet quality and physical activity with cardiovascular disease and mortality in 85,545 older Australians
T2 - A longitudinal study
AU - Ding, Ding
AU - Van Buskirk, Joe
AU - Partridge, Stephanie
AU - Clare, Philip
AU - Giovannucci, Edward
AU - Bauman, Adrian
AU - Freene, Nicole
AU - Gallagher, Robyn
AU - Nguyen, Binh
N1 - Funding Information:
This research was completed using data collected through the 45 and Up study (www.saxinstitute.org.au). The 45 and Up study is managed by the Sax Institute in collaboration with major partner Cancer Council NSW and partners the Heart Foundation and the NSW Ministry of Health. We thank the many thousands of people participating in the 45 and Up study. The project was funded by the Heart Foundation Australia (#101234 and #101583). DD is funded by an Emerging Leader Fellowship from the National Health and Medical Research Council (2009254) and an Early-Mid Career Researcher Grant under the New South Wales Cardiovascular Research Capacity Program. EG is an American Cancer Society Clinical Research Professor (CRP-23-1014041). DD conceptualized the study, conducted literature search, and drafted the paper; BN conducted literature search and supported the paper draft; JVB managed and analyzed the data and supported the paper draft; PC advised on data analysis; all authors contributed to interpreting data. All authors have read and approved the final version of the manuscript, and agree with the order of presentation of the authors. The authors declare that they have no competing interests.
Funding Information:
This research was completed using data collected through the 45 and Up Study ( www.saxinstitute.org.au ). The 45 and Up Study is managed by the Sax Institute in collaboration with major partner Cancer Council NSW and partners the Heart Foundation and the NSW Ministry of Health. We thank the many thousands of people participating in the 45 and Up Study. The project was funded by the Heart Foundation Australia ( #101234 and #10158 3). DD is funded by an Emerging Leader Fellowship from the National Health and Medical Research Council ( 2009254 ) and an Early-Mid Career Researcher Grant under the New South Wales Cardiovascular Research Capacity Program. Edward Giovannucci is an American Cancer Society Clinical Research Professor ( CRP-23-1014041 ).
Publisher Copyright:
© 2024
PY - 2024/11
Y1 - 2024/11
N2 - Background: A quality diet and an active lifestyle are both important cornerstones of cardiovascular disease (CVD) prevention. However, despite their interlinked effects on metabolic health, the 2 behaviors are rarely considered jointly, particularly within the context of CVD prevention. We examined the independent, interactive, and joint associations of diet and physical activity with CVD hospitalization, CVD mortality, and all-cause mortality. Methods: CVD-free Australian participants aged 45–74 years (n = 85,545) reported physical activity, diet, sociodemographic, and lifestyle characteristics at baseline (2006–2009) and follow-up (2012–2015), and data were linked to hospitalization and death registries (03/31/2019 for CVD hospitalization and all-cause mortality and 12/08/2017 for CVD mortality). Diet quality was categorized as low, medium, and high based on meeting dietary recommendations. Physical activity was operationalized as (a) total moderate-to-vigorous physical activity (MVPA) as per guidelines, and (b) the composition of MVPA as the ratio of vigorous-intensity physical activity (VPA) to total MVPA. We used a left-truncated cause-specific Cox proportional hazards model using time-varying covariates. Results: During a median of 10.7 years of follow-up, 6576 participants were admitted to the hospital for CVD and 6581 died from all causes (876 from CVD during 9.3 years). A high-quality diet was associated with a 17% lower risk of all-cause mortality than a low-quality diet, and the highest MVPA category (compared with the lowest) was associated with a 44% and 48% lower risk of CVD and all-cause mortality, respectively. Multiplicative interactions between diet and physical activity were non-significant. For all outcomes, the lowest risk combinations involved a high-quality diet and the highest MVPA categories. Accounting for total MVPA, some VPA was associated with further risk reduction of CVD hospitalization and all-cause mortality. Conclusion: For CVD prevention and longevity, one should adhere to both a healthy diet and an active lifestyle and incorporate some VPA when possible.
AB - Background: A quality diet and an active lifestyle are both important cornerstones of cardiovascular disease (CVD) prevention. However, despite their interlinked effects on metabolic health, the 2 behaviors are rarely considered jointly, particularly within the context of CVD prevention. We examined the independent, interactive, and joint associations of diet and physical activity with CVD hospitalization, CVD mortality, and all-cause mortality. Methods: CVD-free Australian participants aged 45–74 years (n = 85,545) reported physical activity, diet, sociodemographic, and lifestyle characteristics at baseline (2006–2009) and follow-up (2012–2015), and data were linked to hospitalization and death registries (03/31/2019 for CVD hospitalization and all-cause mortality and 12/08/2017 for CVD mortality). Diet quality was categorized as low, medium, and high based on meeting dietary recommendations. Physical activity was operationalized as (a) total moderate-to-vigorous physical activity (MVPA) as per guidelines, and (b) the composition of MVPA as the ratio of vigorous-intensity physical activity (VPA) to total MVPA. We used a left-truncated cause-specific Cox proportional hazards model using time-varying covariates. Results: During a median of 10.7 years of follow-up, 6576 participants were admitted to the hospital for CVD and 6581 died from all causes (876 from CVD during 9.3 years). A high-quality diet was associated with a 17% lower risk of all-cause mortality than a low-quality diet, and the highest MVPA category (compared with the lowest) was associated with a 44% and 48% lower risk of CVD and all-cause mortality, respectively. Multiplicative interactions between diet and physical activity were non-significant. For all outcomes, the lowest risk combinations involved a high-quality diet and the highest MVPA categories. Accounting for total MVPA, some VPA was associated with further risk reduction of CVD hospitalization and all-cause mortality. Conclusion: For CVD prevention and longevity, one should adhere to both a healthy diet and an active lifestyle and incorporate some VPA when possible.
KW - Cardiovascular disease
KW - Cohort studies
KW - Diet
KW - Mortality
KW - Physical activity
UR - http://www.scopus.com/inward/record.url?scp=85197397615&partnerID=8YFLogxK
U2 - 10.1016/j.jshs.2024.05.011
DO - 10.1016/j.jshs.2024.05.011
M3 - Article
C2 - 38810689
AN - SCOPUS:85197397615
SN - 2095-2546
VL - 13
SP - 841
EP - 850
JO - Journal of Sport and Health Science
JF - Journal of Sport and Health Science
IS - 6
ER -